Alogophobia, Kinesiophobia and Chronic Pain

Alogophobia,  Kinesiophobia and Chronic Pain


This morning I fell at work. Hard.  I was in a hurry, putting my purse down in the provider charting area, grabbing my Starbucks red coffee mug and stepped quickly out into the freshly waxed hallway. I didn’t notice that the floor crew had soaked the first two feet of carpet in our little office and my boots were wet.  It was such a strange fall.  I had no sensation of falling at all. I was just suddenly face down on the floor, landing mostly on my left knee, hip and outstretched hand.

My knee is bruised and hand are bruised and my left thigh started cramping up by the end of the day. I put an ice pack on every time I sat down to chart. Here is what I know: I am going to be just fine. I will probably be a little more sore tomorrow but my body is designed to heal. I am not going to sue. I am not going to develop any chronic pain syndrome as a result of this fall. I am not going to believe that I will develop arthritis of my knee or that I did anything to discs in my back that won’t heal on its own.

Sadly, many of the chronic pain patients that I see have had similar minor accidents or falls sometimes as long as twenty years ago that set their lives into a tailspin of chronic pain syndrome. When I talk to them, they tell me that they have degenerative disc/back/knee problems.   There were told by someone they respected that they will develop arthritis in the area of injury. They may have been told that they have a bulging disc, which they may have had before the injury since many times this is asymptomatic. They believe that discs can never improve or heal.

The most interesting thing to me is that they become afraid to move. They are convinced beyond reason that  if they move or exercise they will do damage to their area of injury. This idea remains fixed for what seems to me to be the rest of their life. Physical therapy has never worked for them because they are convinced that the pain means that something is wrong. Really wrong and it not going to heal ever.

Today, I tried to “walk it off” between icing the knee and thigh. I stretched my back gently. I believe that if I sit still, my muscles will spasm. I believe I will be fine. I don’t need Norco or likely even Tylenol for pain. Trust me, the bruises and swelling are pretty impressive. I know I will be just fine because I am not afraid. No one put a soft collar on my neck or took x rays of anything.

I love my vocation. I am happy with my life. But what if I were unhappy? What if I hated my job? What if I believed in lawsuits for slip and fall? What if I didn’t know all the things that I know about pain and the brain? I could be off work for months as many patients that I see are. Some patients are off for more than a year for a very simple slip and fall.

I think one of the most important things we need to do is to teach people that our bodies are designed to heal. There is virtually nothing that is made better by prolonged rest. Teach that the longer you rest, the more the muscles atrophy, weaken and weak muscles hurt when you use them. We need to teach that pain does not always mean disability.

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